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MRS. KELLY ANNE BRAINARD LMFT
>> Rehabilitation Practitioner >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1699891366
Individual Registrant:MRS. KELLY ANNE BRAINARD LMFT
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
25129 THE OLD ROAD SUITE 201 STEVENSON RANCH, CA 91381-2276 US
Tel: 661-294-3898 Fax: 661-294-3898
Tel: 661-294-3898 Fax: 661-294-3898
Contact information for business:
25129 THE OLD ROAD SUITE 201 STEVENSON RANCH, CA 91381-2276 US
Tel: 661-294-3898 Fax: 661-294-3898
Tel: 661-294-3898 Fax: 661-294-3898
Registration Information:
NPI: 1699891366
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 225400000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Rehabilitation Practitioner | CA | IMF 45082 |
| Y | 106H00000X | Behavioral Health & Social Service Providers Marriage & Family Therapist | CA | MFC 44454 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
